STEPHANIE K FRASER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****90

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

FRASER

Business Name

STEPHANIE K FRASER

Original Issue Date

07/22/2019

Effective Date

07/22/2019

Expiration Date

03/01/2020

City

O'FALLON

State

Zip

62269

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020